HomeMy WebLinkAboutPermit Mechanical 1991-10-16
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RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOrED W( ORK' - q n
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DESCRIBE WORK:li)1l ~v, ~\ U\rQ.f'Q ..
NEW REMODEL ADDI I~ DEMOLISH
I
pLUMBING'
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LAND USF' ,\ \
LOT'
CONTRACTOR'S NAME
GENERA' .
ELECTRICAl'
QUAD AREA:
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# OF BLDGS:
OCCY GROUP'
# OF STORIES:
WATER HEATER'
OTHER
ADDRESS
CONST.
CONTRACTOR #
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i
C\\ \2.~2-
# OF UNITS'
CONSTR. TYP'"
HEAT SOURCE:
RANnJ;:.
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
(" J\ /\ I Y')
. \ II
SUBDIVISION'
EXPIRES
PHONE
l~.IkfJ'b,
FLOOD PLAIN'
ZONING CODE:
# OF BDRMS'
SECONDARY HEAT'
SQUARE FOOTAGE:
To request an inspection, you must call 726,3769. This is a 24 hour recording. All inspections requested before 7:00 a.m. will be
made the same working day, Inspections requested after 7:00 a,m. will be made the following work day.
D Tempol'a[y..Electric
D Site Inspection - To be made
atter excavation, but prior to
setting forms.
D
Underslab Plumbingl Electrical I
Mechanical - Prior to cover.
D Footing - After trenches afe
excavated.
D
Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
p
Underfloor Plumbing/Mechanical
- Prior to Insulation or deckIng.
D
Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking,
D
Sanitary Sewer - Prior to filling
trench.
D
Storm Sewer - Prior to filling
trench. 0:
D Water Line - Prior to flll1rg
trench. '\
D Rough Plumbing - Prior to,
cover.
REQUIRED INSPECTIONS
~OU9h Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wall/Ceiling Insulation - Prl'or to
cover.
D Drywall - Prior to taping.
..
D Wood Stove""",,:, After Installation.
D Insert - After fireplace approval
and Installation of unit.
D
Curbcut & Approach - After
forms are erected but prior to
'placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material in place,
D Fence - When completed.
, D ,Street Trees - 'When all required
trees are planted. '
,
D
Final Plumbing - When all
plumbIng work Is complete.
D Final Electrical - When all
electrical work is complete. .
~inal Mechanical - When all
T mechanical work is compl~te.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
DOther
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set-up, and plumbing
inspections have been' approved
and the home Is connected to
the servIce panel.
D Final - After all required
inspections are approved and
, porches, skirting; decks, and
venting have been Installed.
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Lot faces - Lot Type .. Setbacks . THE PROPOSED WORK IN THE
Lot sq. ftg. Interior I PL. HSE GAR ACC I HI~TORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I and approved by the Historical
Topography Panhandle Iw 'I Coordinator prior to permit Issuance.
Total height Cul.de-sac IE I
APPROVED'
BUILDING PERMIT
ITEM SO, FT. X $/SO. FT.
VALUE
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC).
(8) '--
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential 8ath(s)
N'
Sanitary Sewer
FT.
FT.
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unfit:
crnntJl . Q)R miI
'Mechanical Permit \
Issuance
/ 5 .00
!O.CXJ
_} ,6tS
(,{)(O.0JS
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding elec;rICal)c1I.I?-~
(A, S, C, D, and E Combined)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee'
Date Paid:
Receipt Number.
Received By:
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all required Inspections are
requested at the proper time: that each address is readable
from the street, that the permit card Is located at the front
of the proper ,and the approved set of lans will remain
on the site all times ding nstru tion.
Slg
Date
,
VALIDATION: -~ /IoID
RECEIPT NUM8Ec'- r:::)(. _
DATE PAID ({), / Kh' Cj /
AMOUNT REr'"'~- .1 ',c:Y0,.:20
RECEIVED S\< _ ~
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